MEDICARE: MAURICE N LEIBMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	F4926	TX
2	207VG0400X	Gynecology Physician	F4926	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	160006654-	OTHER	TX	MEDICARE RR-SW LOCATION
6	TXB113640	OTHER	TX	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	682896	OTHER	TX	AETNA
2	88W578	OTHER	TX	BC/BS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	4565782-002	OTHER	TX	CIGNA

General Provider Information

NPI Number	:	1023017001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAURICE N LEIBMAN MD

Provider Business Mailing Address
First Line	:	12727 KIMBERLEY LN
Second Line	:	202
City	:	HOUSTON
State	:	TX
Zip	:	77024-4047
Country	:	US
Telephone Number	:	713-275-2990
Fax Number	:	713-275-1694

Provider Business Practice Location Address
First Line	:	12727 KIMBERLEY LN
Second Line	:	202
City	:	HOUSTON
State	:	TX
Zip	:	77024-4047
Country	:	US
Telephone Number	:	713-275-2990
Fax Number	:	713-275-1694

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	02/23/2011

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Directions to “ MAURICE N LEIBMAN MD” Practice Location

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